RN instructed patient about medication Famotidine that is used to treat gastroesophageal reflux disease, a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus. RN instructed patient to swallow the tablets and capsules with a full glass of water. RN also explained about side effects of treatment such as: hives, skin rash, itching, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs. RN instructed to call Physician immediately if any of these signs or symptoms appear. Patient and caregiver voiced understanding of all instructions given.
RN instructed patient and caregiver on hypertensive urgency which is a situation where the blood pressure is severely elevated and may or may not experience one or more of these symptoms: Severe headache, shortness of breath, nosebleeds, and severe anxiety, chest or back pain, numbness or weakness of extremities, change in vision and difficulty speaking and immediately ask for medical assistance calling 9-1-1. RN instructed patient and caregiver on no-added-salt or salt-controlled diet that can help control high blood pressure. Both patient and caregiver verbalized understanding.
SN instructed patient on high blood pressure. The high blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
SN instructed patient that phantom pain is very real but not everyone who has an amputation has phantom pain. The pain may feel like cramping, burning, stabbing or shooting pain. Some things that can make the pain feel worse are being too tired, too much pressure on the amputated arm or leg, changes in the weather, stress and infection.
SN instructed patient on diabetes and kidney problem, that diabetes mellitus ( DM ) is one of the leading cause of kidney failure in the United States. Approximately one-half of people who need dialysis have kidney disease from diabetes.With that, tight control of blood sugar must be done by avoiding concentrated sweets and high-carbohydrate content foods.Diabetic patients with hypertension have a special lower blood pressure target of less than 130 / 80 mmHg to reduce cardiovascular risk and delay progression of kidney disease.
SN instructed patient on liver failure. The early symptoms of liver failure are similar to symptoms of many other conditions. Because of this, liver failure may initially difficult to diagnose. Some of the most common initial symptoms of liver failure are: Nausea, Loss of appetite, fatigue, diarrhea. As liver failure progresses, the symptoms become more serious. The most common symptoms of advanced liver failure include: Skin itchiness, jaundice, bleeding easily, bruising easily, swollen abdomen, mental disorientation or confusion, sweet or foul smelling breath, sleepiness, coma. Educated patient that the liver filters the Ammonia out the blood and that liver failure causes Ammonia levels to increase, which cause change of mental status, confusion, and sleepiness or fatigue.
SN instructed that should be call your doctor right away if you notice any of the following signs and symptoms of an infection: Fever ( this is sometimes the only sign of an infection ), chills and sweats, change in cough or a new cough, sore throat or new mouth sore, shortness of breath, nasal congestion, stiff neck, burning or pain with urination, unusual vaginal discharge or irritation, increased urination, redness, soreness, or swelling in any area, including surgical wounds and ports, diarrhea, vomiting, pain in the abdomen or rectum, new onset of pain.
SN instructed patient on arthropathy: Encouraged frequent changes of position. Assisted patient to move in bed, supporting affected joints above and below, instructed her to avoid jerky movements. Recommend that patient take warm bath or shower upon arising or at bedtime. Apply warm, moist compresses to affected joints several times a day. Monitor water temperature of compress, baths, and so on. Encouraged patient on stress management techniques such as progressive relaxation, biofeedback, visualization, guided imagery, self-hypnosis, and controlled breathing.Verbalized understanding.
SN instructed on Alzheimer's. Patient shouts at moments; Assessed patient’s ability for thought processing. Observed patient for cognitive functioning, memory changes, disorientation, difficulty with communication, or changes in thinking patterns. Assessed patient’s ability to cope with events, interests in surroundings and activity, motivation, and changes in memory pattern. Instructed caregiver to orient patient to environment as needed, if patient’s short term memory is intact. Using of calendars, radio, newspapers, television and so forth, are also appropriate. Assessed patient for sensory deprivation, concurrent use of CNS drugs, poor nutrition, dehydration, infection, or other concomitant disease processes. Maintain a regular daily schedule routine to prevent problems that may result from thirst, hunger, lack of sleep, or inadequate exercise. Provide positive reinforcement and feedback for positive behaviors. SN instructed family in methods to use with communication with patient: listen carefully, listen to stories even if they’ve heard them many times previously, and to avoid asking questions that the patient may not be able to answer. Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed. Eliminate or minimize sources of hazards in the environment. Caregiver verbalized fair understanding.
SN instructed in possible complication of PVD such as ulcers, cellulites, gangrene, thrombophlebitis, etc. SN instructed patient to walk for at least 15 minutes three to four times per day, gradually increasing her pace and duration of exercise. It is recommended not to cross the legs, which may interfere with blood flow; manage swelling by elevating the feet at rest. Vasodilation can be achieved by providing warmth to the affected extremity and preventing long periods of exposure to cold; maintain a warm environment at home and wear socks or insulated shoes at all times. Never apply direct heat to the limbs, such as with the use of a heating pad or extremely hot water to reduce the risk of burns. Verbalized understanding.